I really don't want to be a doctor

Chapter 63 Laparoscopic Cholecystectomy
In fact, when the laparoscope was first invented, it was used for inspection.

However, with the passage of time, some techniques were created.

The first laparoscopic surgery,

It's cholecystectomy.

Unlike laparoscopic appendectomy, laparoscopic cholecystectomy is highly regarded.

After all, compared to going from a 4cm incision to three 1cm incisions for an appendectomy,

From more than ten centimeters open cholecystectomy to three 1cm incisions,
Such a breakthrough is leaps and bounds.

The patient is now lying on the operating table, and the cause is basically determined.

Laparoscopic cholecystectomy is the best option for this patient.

Yu Wenxing is not a saint either.

But this patient was placed on his own operating table voluntarily or passively, so he had to be responsible for this patient.

Optimal solution,

It was what Yu Wenxing wanted to do.

And it just so happened that he was able to complete this optimal solution.

"Is this patient an indication for gallbladder surgery?"

Yu Wenxing asked.

Li Xiaojun was still surprised.

He was not surprised that Yu Wenxing was able to perform open appendectomy.

Yu Wenxing was able to perform laparoscopic appendectomy. Although he was surprised, he felt that it was reasonable. After all, this is appendectomy.

But Yu Wenxing said at this moment that he would do laparoscopic cholecystectomy,

Li Xiaojun was a little confused.

If you want to take the cholecystectomy as the chief surgeon, you usually have to go to the attending physician.

A surgery does not mean that you can do it after watching many videos or reading many books. The accumulation of experience is the most important thing.

The gallbladder is no bigger than the appendix.

There are more complex structures surrounding the gallbladder.

There are more important organs around the gallbladder.

The anatomy of the gallbladder triangle can reveal the general level of a surgeon.

This sentence is not groundless.

If the gallbladder triangle can be successfully separated, then this doctor's general surgery level can be regarded as firmly entering the intermediate ranks.

Li Xiaojun recalled the day when he had his first open cholecystectomy,

It seems that it is not far from now.

And now.
an intern,

Going to have a gallbladder removed!

And it was laparoscopic cholecystectomy!

Li Xiaojun felt a little unreal.

When Yu Wenxing spoke, Li Xiaojun woke up from his own daze, but he did not deny Yu Wenxing's problem.

Acute exacerbation of chronic cholecystitis is indeed one of the indications for cholecystectomy.

"Is it possible to cut the gallbladder under a laparoscope?"

Yu Wenxing asked again.

"of course."

Li Xiaojun nodded again, of course he knew that the gallbladder can be cut under the laparoscope, after all, this is the first method of laparoscopic surgery.

But now the problem is.
"But will you really?"

Li Xiaojun asked uncertainly.

Yu Wenxing nodded sincerely.

Li Xiaojun felt his scalp go numb.

He knew that his next choice was very important.

Unlike laparoscopic appendectomy.

Even if laparoscopic appendectomy fails, or even if the appendix artery is damaged, there is still a remedy, at worst, open the abdomen to remedy it.

But laparoscopic cholecystectomy, once the common bile duct is damaged, it is almost impossible to make up.

but,

Looking at Yu Wenxing's determined look,
Li Xiaojun bit the bullet and nodded heavily, "Be careful."

He believed that Yu Wenxing would not target indiscriminately,

Only carefully clenched his fists to reduce the sweat under the gloves.

Yu Wenxing nodded, and the operation continued.

The location of the gallbladder is clearly visible, and the next thing to do is to cut the gallbladder out.

It's different from Li Xiaojun's nervousness.

Yu Wenxing didn't have the slightest psychological pressure.

He has done thousands of laparoscopic cholecystectomy.

He started when he started graduate school.

Although, among the thousands of operations, he was at least half of them as an assistant.

Although, among the thousands of operations, most of them are routine cases.

However, the patient's condition has not yet exceeded the scope of conventional cases.

First, check the basic condition of the gallbladder and its surroundings.

Yu Wenxing nodded while watching.

There are some adhesions around the gallbladder, proving the existence of inflammation.

However, the gallbladder was not too congested and edematous, and no signs of gangrene were seen.

This is a very simple case of gallbladder removal.

Another look at the liver.

Many yellow fat particles can be seen on the liver.

"Oh, fatty liver."

Yu Wenxing laughed.

"Ha ha."

Li Xiaojun responded with a dry smile,
He hadn't even seen a couple of videos about laparoscopic gallbladder removal.

Gently grasp the gallbladder, the structure of the gallbladder triangle is clearly visible.

"Steady the mirror, the gallbladder triangle is about to be divided."

Yu Wenxing reminded.

He could also see that Li Xiaojun was nervous.

Of course he also understands why Li Xiaojun is nervous,

The two of us, a little too bold.

Li Xiaojun nodded upon hearing this, rubbed his hands through the gloves, and then firmly grasped the mirror.

Anatomy of the gallbladder triangle,

This is a critical step in cholecystectomy,

Either laparotomy or laparoscopically.

Cut the frontal serosa at a distance from the common bile duct in resection mode,
Yu Wenxing's hand was very steady, and he chose the electric cutting mode to avoid damaging the surrounding tissues.

Immediately,

Yu Wenxing cut the serosa at the back again.

back to the front,

Continue to bluntly and sharply separate the serosa until the gallbladder triangle is completely exposed.

also until now,
Only then did Li Xiaojun understand Yu Wenxing's surgical procedures.

This is probably like a person in a strange city, wandering around under the guidance of friends, he has to go to the place he is most familiar with before he reacts,

Oh, it turned out to be here.

Li Xiaojun felt this way right now.

Oh.
It turns out that this is the gallbladder triangle dissected by laparoscopy.

gallbladder triangle,

It is composed of the cystic duct, the common hepatic duct, and the lower edge of the liver, resembling a pair of briefs, commonly known as the gallbladder triangle.

In this area,
Particular attention should be paid to the cystic duct and cystic artery.

Yu Wenxing glanced at it,
The cystic artery was of normal size, and he breathed a sigh of relief.

After all, if it is too small, you have to explore other branches of the cystic artery, which undoubtedly greatly prolongs the operation time.

And if it is too big, you have to be careful whether it is other blood vessels.

The structures of the cystic duct, common hepatic duct, and common bile duct are clearly visible.

"Clip."

Yu Wenxing pulled out a joystick and said softly.

Tang Ling hurriedly brought the clip over.

This is the difference between nurses and doctors. Nurses only need to know what to hand, while doctors need to know how to use the things handed over.

The cystic duct was cut off after clamping at a position 0.5 cm below the common bile duct and clamping at a position close to the gallbladder above.

Then, the proximal end of the cystic artery was clipped, and the distal end was cut off by electrocoagulation.

Cholecystectomy is basically half done.

Next, the gallbladder bed is stripped.

(End of this chapter)